{"id":388,"date":"2024-03-07T07:29:49","date_gmt":"2024-03-07T07:29:49","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=chapter&#038;p=388"},"modified":"2025-05-09T11:23:21","modified_gmt":"2025-05-09T11:23:21","slug":"major-baglayicilar","status":"publish","type":"chapter","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/chapter\/major-baglayicilar\/","title":{"raw":"Major Ba\u011flay\u0131c\u0131lar","rendered":"Major Ba\u011flay\u0131c\u0131lar"},"content":{"raw":"\u00c7enelerin anatomik yap\u0131lar\u0131ndaki farkl\u0131l\u0131klar nedeniyle, alt ve \u00fcst \u00e7enede kullan\u0131lan ana ba\u011flay\u0131c\u0131lar\u0131n yap\u0131s\u0131 ve \u00e7e\u015fitleri birbirinden farkl\u0131d\u0131r.\r\n\u00dcst \u00c7ene Ana Ba\u011flay\u0131c\u0131lar\u0131\r\n\u00dcst \u00e7ene ana ba\u011flay\u0131c\u0131s\u0131n\u0131n dokuya oturacak i\u00e7 y\u00fczeyinde, periferal duvar boyunca, stop \u00e7izgisi olu\u015fturulur. Ana ba\u011flay\u0131c\u0131n\u0131n dokuya g\u00f6m\u00fclmesini \u00f6nleyen bu olu\u015fum ana ba\u011flay\u0131c\u0131yla doku aras\u0131nda iyi bir adaptasyon sa\u011flayarak, alt\u0131na g\u0131da ka\u00e7\u0131\u015f\u0131n\u0131 \u00f6nler. Stop \u00e7izgisi, hareketli b\u00f6l\u00fcml\u00fc protezin yap\u0131laca\u011f\u0131 ana model \u00fczerinde 0.5 - 1.0 mm derinlik ve geni\u015flikte oluk ha\u00adz\u0131rlanarak yap\u0131l\u0131r ve di\u015flerin gingival kenar\u0131ndan 6 mm uzakta sonlanmal\u0131d\u0131r. Stop \u00e7izgisinin derinli\u011fi, ana ba\u011flay\u0131c\u0131n\u0131n alt\u0131nda kalan dokunun reziliensine g\u00f6re belirlenir. Bu derinlik sert palatal mukozan\u0131n lateral e\u011fimleri boyunca daha derin, median palatal suturan\u0131n ge\u00e7ti\u011fi horizontal b\u00f6lgede ise daha s\u0131\u011f haz\u0131rlan\u0131r.\r\n\r\n\u00dcst \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131:\r\n<ul>\r\n \t<li>Palatal bant,<\/li>\r\n \t<li>\u00c7ift damak bar\u0131,<\/li>\r\n \t<li>U-plak,<\/li>\r\n \t<li>Tam palatal plak.<\/li>\r\n<\/ul>\r\n<h2>Palatal Bant<\/h2>\r\nEksik di\u015flerin yerine ba\u011fl\u0131 olmas\u0131na ra\u011f\u00admen, s\u0131kl\u0131kla \u00f6n kenar\u0131 ruga seviyesinde, arka kenar\u0131 ise sert dama\u011f\u0131n ge\u00e7i\u015f b\u00f6lge\u00adsinde olmak \u00fczere, serbest di\u015feti kenarla\u00adr\u0131n\u0131 \u00f6rtmeyen ve e\u015fit kal\u0131nl\u0131kta olan bir bant \u00f6zelli\u011findedir. Damak \u00f6n b\u00f6lgesi a\u00e7\u0131kta b\u0131ra\u00adk\u0131ld\u0131\u011f\u0131ndan, fonasyona engel olmaz ve hasta i\u00e7in en rahat ana ba\u011flay\u0131c\u0131d\u0131r. Di\u015fsiz kretlerin daha k\u0131sa oldu\u011fu vakalarda daha dar, uzun oldu\u011fu vakalarda daha geni\u015f yap\u0131labilir; an\u00adcak en az 8 mm geni\u015fli\u011fe sahip olmal\u0131d\u0131r. Deformasyona direncini artt\u0131rmak amac\u0131yla, y\u00fczeyi dar, kal\u0131nl\u0131\u011f\u0131 fazla veya y\u00fczeyi geni\u015f, kal\u0131nl\u0131\u011f\u0131 ince yapmak gerekir. Sert damakla geni\u015f bir temas sahas\u0131 olu\u015fturdu\u011funda, iyi bir palatal destek sa\u011flayabilir. S\u0131kl\u0131kla kullan\u0131lan bir \u00fcst \u00e7ene ana ba\u011flay\u0131c\u0131s\u0131d\u0131r.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>Di\u015f destekli di\u015fsiz bo\u015fluklar\u0131n di\u015f ark\u0131n\u0131n her iki taraf\u0131nda simetrik olarak bulundu\u011fu Cl III modifikasyonlar\u0131 (\u015eekil 5-1),\r\n\r\n[caption id=\"attachment_397\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1.jpg\"><img class=\"size-medium wp-image-397\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-300x233.jpg\" alt=\"\u015eekil 5-1. Palatal bant \u015feklindeki ana ba\u011flay\u0131c\u0131, modifikasyonlu Cl III gibi di\u015f destekli vakalarda daha dar olabilir.\" width=\"300\" height=\"233\" \/><\/a> <strong>\u015eekil 5-1.<\/strong> Palatal bant \u015feklindeki ana ba\u011flay\u0131c\u0131, modifikasyonlu Cl III gibi di\u015f destekli vakalarda daha dar olabilir.[\/caption]<\/li>\r\n \t<li>Damak \u00f6n b\u00f6lgesinin a\u00e7\u0131k b\u0131rak\u0131lmas\u0131n\u0131 gerektiren baz\u0131 Cl I ve II Mod. 1 (\u015eekil 5-2),\r\n\r\n[caption id=\"attachment_398\" align=\"alignnone\" width=\"639\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2.jpg\"><img class=\"wp-image-398 size-full\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2.jpg\" alt=\"\u015eekil 5-2. Cl I Mod 1(a) ve Cl II Mod 1 (b) vakalar\u0131nda oldu\u011fu gibi, sert damak deste\u011finin artt\u0131r\u0131lmas\u0131 istendi\u011finde, palatal bant daha geni\u015f haz\u0131rlanabilir.\" width=\"639\" height=\"269\" \/><\/a> <strong>\u015eekil 5-2.<\/strong> Cl I Mod 1<br \/><strong>(a)<\/strong> ve Cl II Mod 1<br \/><strong>(b)<\/strong> vakalar\u0131nda oldu\u011fu gibi, sert damak deste\u011finin artt\u0131r\u0131lmas\u0131 istendi\u011finde, palatal bant daha geni\u015f haz\u0131rlanabilir.[\/caption]<\/li>\r\n \t<li>Kar\u015f\u0131t ark kavram\u0131 gere\u011fince, deste\u011fin di\u015fli ark k\u0131sm\u0131ndan sa\u011flanmas\u0131 amac\u0131yla Cl II ve Cl III vakalar\u0131 (\u015eekil 5-3 ).<\/li>\r\n<\/ol>\r\n[caption id=\"attachment_399\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3.jpg\"><img class=\"size-medium wp-image-399\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-300x242.jpg\" alt=\"\u015eekil 5-3. Cl III vakalar\u0131nda, kar\u015f\u0131t arktan destek almak amac\u0131yla palatal bant kullan\u0131labilir; ancak geni\u015fli\u011fi 8 mm\u2019den az olmamal\u0131d\u0131r.\" width=\"300\" height=\"242\" \/><\/a> <strong>\u015eekil 5-3<\/strong>. Cl III vakalar\u0131nda, kar\u015f\u0131t arktan destek almak amac\u0131yla palatal bant kullan\u0131labilir; ancak geni\u015fli\u011fi 8 mm\u2019den az olmamal\u0131d\u0131r.[\/caption]\r\n\r\n<strong>Kontrendikasyon:<\/strong>\r\n<ol>\r\n \t<li>Torus palatinus varl\u0131\u011f\u0131,<\/li>\r\n \t<li>Sert dama\u011f\u0131n anatomik formunun \u00e7ok sert ve d\u00fcz olmas\u0131,<\/li>\r\n \t<li>Di\u015fsiz sahalar\u0131n da\u011f\u0131l\u0131m\u0131n\u0131n uygun olmamas\u0131.<\/li>\r\n<\/ol>\r\n<h2>\u00c7ift Damak Bar\u0131<\/h2>\r\nAnterior ve posterior b\u00f6lgede yer alan iki damak bar\u0131 \u015feklindedir. Rugan\u0131n girinti ve \u00e7\u0131k\u0131n\u00adt\u0131lar\u0131na g\u00f6re geni\u015f ve d\u00fcz olarak \u015fekillendirilen anterior bar dili rahats\u0131z edip fonasyona engel olmaz. Posterior bar ise anterior bara g\u00f6re daha kal\u0131n ve dar olacak \u015fekilde di\u015fsiz bo\u015flu\u011fun durumuna g\u00f6re yerle\u015ftirilir. Palatal banta g\u00f6re, deformasyona direnci daha iyidir; ancak doku deste\u011fi a\u00e7\u0131s\u0131ndan daha etkisizdir. Barlar d\u0131\u015f\u0131nda kalan k\u0131s\u0131mlar\u0131n a\u00e7\u0131k olu\u015fu hasta i\u00e7in rahatl\u0131k temin eder.\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>\u00d6n ve arka b\u00f6lgedeki destek di\u015fler aras\u0131ndaki mesafenin fazla oldu\u011fu modifikasyonlu Cl II (\u015eekil 5-4) ve Cl III vakalar\u0131 (\u015eekil 5-5),<\/li>\r\n<\/ol>\r\n[caption id=\"attachment_489\" align=\"alignleft\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4.jpg\"><img class=\"wp-image-489 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-300x225.jpg\" alt=\"\u015eekil 5-4. \u00d6n b\u00f6lgedeki bar\u0131 geni\u015f ve d\u00fcz, arka b\u00f6lgedeki bar\u0131 ise dar ve ince olarak haz\u0131rlanan \u00e7ift damak bar\u0131 modifikasyonlu Cl II vakalar\u0131nda kullan\u0131labilir.\" width=\"300\" height=\"225\" \/><\/a> <strong>\u015eekil 5-4.<\/strong> \u00d6n b\u00f6lgedeki bar\u0131 geni\u015f ve d\u00fcz, arka b\u00f6lgedeki bar\u0131 ise dar ve ince olarak haz\u0131rlanan \u00e7ift damak bar\u0131 modifikasyonlu Cl II vakalar\u0131nda kullan\u0131labilir.[\/caption]\r\n\r\n[caption id=\"attachment_565\" align=\"alignright\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5.jpg\"><img class=\"wp-image-565 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-300x210.jpg\" alt=\"\u015eekil 5-5. \u00c7ift damak bar\u0131, uzun di\u015fsiz kretlere sahip modifikasyonlu Cl III vakalar\u0131nda da kullan\u0131labilir.\" width=\"300\" height=\"210\" \/><\/a> <strong>\u015eekil 5-5.<\/strong> \u00c7ift damak bar\u0131, uzun di\u015fsiz kretlere sahip modifikasyonlu Cl III vakalar\u0131nda da kullan\u0131labilir.[\/caption]\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n2. Torus palatinus varl\u0131\u011f\u0131nda,\r\n\r\n3. Tam palatal pla\u011f\u0131 tolere edemeyen hastalar.\r\n\r\n4. \u00d6n b\u00f6lgedeki di\u015f eksikli\u011fini desteklemek \u00fczere Cl IV vakalar\u0131nda, palatal bant anterior b\u00f6lgeye uzat\u0131l\u0131r (\u015eekil 5-6).\r\n\r\n&nbsp;\r\n\r\n[caption id=\"attachment_616\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6.jpg\"><img class=\"size-medium wp-image-616\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-300x212.jpg\" alt=\"\u015eekil 5-6. Cl IV vakalar\u0131nda, \u00e7ift damak bar\u0131n\u0131n \u00f6n k\u0131sm\u0131, \u00f6n b\u00f6lgedeki di\u015fsiz krete kadar uzat\u0131l\u0131r. Major ba\u011flay\u0131c\u0131n\u0131n lateral b\u00f6l\u00fcmleri, di\u015flerin gingival marjinlerinden en az 6 mm uzakta konumlanmal\u0131d\u0131r.\" width=\"300\" height=\"212\" \/><\/a> <strong>\u015eekil 5-6.<\/strong> Cl IV vakalar\u0131nda, \u00e7ift damak bar\u0131n\u0131n \u00f6n k\u0131sm\u0131, \u00f6n b\u00f6lgedeki di\u015fsiz krete kadar uzat\u0131l\u0131r. Major ba\u011flay\u0131c\u0131n\u0131n lateral b\u00f6l\u00fcmleri, di\u015flerin gingival marjinlerinden en az 6 mm uzakta konumlanmal\u0131d\u0131r.[\/caption]\r\n<h2>U-Plak<\/h2>\r\nDamak \u00f6n b\u00f6lgesini \u00f6rterek yan arka b\u00f6lgelere uzanan, at nal\u0131 \u015feklinde bir ana ba\u011flay\u0131c\u0131 tipidir (\u015eekil 5-7).\r\n\r\n[caption id=\"attachment_618\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7.jpg\"><img class=\"wp-image-618 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-300x226.jpg\" alt=\"\u015eekil 5-7. U plak, damak \u00f6n b\u00f6lgesini \u00f6rten ve yan arka b\u00f6lgelere uzanan bir ana ba\u011flay\u0131c\u0131 tipidir.\" width=\"300\" height=\"226\" \/><\/a> <strong>\u015eekil 5-7.<\/strong> U plak, damak \u00f6n b\u00f6lgesini \u00f6rten ve yan arka b\u00f6lgelere uzanan bir ana ba\u011flay\u0131c\u0131 tipidir.[\/caption]\r\n\r\nHastaya rahats\u0131zl\u0131k vermemesi i\u00e7in en az 0.5 mm kal\u0131nl\u0131\u011f\u0131nda olmal\u0131d\u0131r. Fonasyon g\u00fc\u00e7l\u00fc\u00ad\u011f\u00fcn\u00fc azaltmak i\u00e7in damak \u00f6n y\u00fcz\u00fcndeki anatomik r\u00f6lyefleri a\u011f\u0131z bo\u015flu\u011funa bakan y\u00fczeyde aynen yans\u0131t\u0131r. M\u00fcmk\u00fcn oldu\u011funca gingival marjinler a\u00e7\u0131kta b\u0131rak\u0131l\u0131r.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>\u00d6n grup di\u015flerin restorasyonunu gerektiren modifikasyonlu Cl I vakalar\u0131,<\/li>\r\n \t<li>\u00d6n ve arka grup di\u015flerin restorasyonunu gerektiren vakalar,<\/li>\r\n \t<li>Torus palatinus\u2019un varl\u0131\u011f\u0131,<\/li>\r\n \t<li>Periodontal deste\u011fi zay\u0131f olan \u00f6n grup di\u015flerin stabilizasyonu gerekti\u011finde,<\/li>\r\n \t<li>Yumu\u015fak damak refleksi fazla olan hastalarda ve\/veya hastan\u0131n damak arka b\u00f6lgesinde doku \u00f6rt\u00fcm\u00fcn\u00fc tolere edemeyece\u011fi durumlar.<\/li>\r\n<\/ol>\r\n<strong>Kontrendikasyon:<\/strong>\r\nSerbest sonlu vakalarda, at nal\u0131 \u015feklindeki bu ana ba\u011flay\u0131c\u0131n\u0131n orta hat b\u00f6lgesinin dar ol\u00admas\u0131, rijiditesini azalt\u0131p, yeterli kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamayaca\u011f\u0131ndan, anterior di\u015flere kadar uzanmadan \u015fekillendirilmesi \u00f6nerilmez (\u015eekil 5-8).\r\n\r\n[caption id=\"attachment_619\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8.jpg\"><img class=\"size-medium wp-image-619\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-300x265.jpg\" alt=\"\u015eekil 5-8. U pla\u011f\u0131n orta hat b\u00f6lgesindeki rijiditesinin azalmas\u0131 kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamad\u0131\u011f\u0131ndan, serbest sonlu vakalarda anterior di\u015flere kadar uzanmadan kullan\u0131m\u0131 \u00f6nerilmez.\" width=\"300\" height=\"265\" \/><\/a> <strong>\u015eekil 5-8.<\/strong> U pla\u011f\u0131n orta hat b\u00f6lgesindeki rijiditesinin azalmas\u0131 kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamad\u0131\u011f\u0131ndan, serbest sonlu vakalarda anterior di\u015flere kadar uzanmadan kullan\u0131m\u0131 \u00f6nerilmez.[\/caption]\r\n<h2>Tam Palatal Plak<\/h2>\r\nSert dama\u011f\u0131 m\u00fcmk\u00fcn oldu\u011fu kadar geni\u015f \u015fekilde kaplayan ve maksimum mukoza deste\u00ad\u011fi sa\u011flayan bir ana ba\u011flay\u0131c\u0131d\u0131r. B\u00f6ylece fonksiyonel y\u00fck geni\u015f sahaya da\u011f\u0131l\u0131p, birim y\u00fczeye d\u00fc\u015fen y\u00fck miktar\u0131 azal\u0131r ve fizyolojik avantaj sa\u011flar. Kaidenin fonksiyonel kuvvetler alt\u0131ndaki hareketi, artan adezyon kuvveti nedeniyle azal\u0131r.\r\n\r\nSert dama\u011f\u0131n do\u011fal anatomik yap\u0131s\u0131n\u0131 pla\u011f\u0131n a\u011f\u0131z bo\u015flu\u011funa bakan y\u00fczeyine ay\u00adnen yans\u0131tmak amac\u0131yla ince olmas\u0131 gerekir; 0.35 mm kal\u0131nl\u0131k yeterlidir. Gingival marjinler m\u00fcmk\u00fcn oldu\u011funca a\u00e7\u0131kta b\u0131rak\u0131l\u0131r.\r\nProtez kenarlar\u0131 arka b\u00f6lgede tam protez kaide hudutlar\u0131 gibi \u015fekillendirilir. Arka hudut metalle tamamlanabildi\u011fi gibi (\u015eekil 5-9) akrilikten de yap\u0131labilir (\u015eekil 5-10).\r\n<table class=\"aligncenter\" style=\"border-collapse: collapse;width: 50.001%;height: 355px\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 340px\">\r\n<td style=\"width: 100%;height: 340px\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9.jpg\"><img class=\"size-medium wp-image-621\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-300x258.jpg\" alt=\"\u015eekil 5-9. Arka hududu yumu\u015fak ve sert dama\u011f\u0131n birle\u015fim b\u00f6lgesinde yer alan tam palatal pla\u011f\u0131n \u00f6n b\u00f6lgesi, singulum t\u0131rnaklar\u0131 ile desteklenmi\u015ftir.\" width=\"300\" height=\"258\" \/><\/a><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 100%\"><strong>\u015eekil 5-9.<\/strong> Arka hududu yumu\u015fak ve sert dama\u011f\u0131n birle\u015fim b\u00f6lgesinde yer alan tam palatal pla\u011f\u0131n \u00f6n b\u00f6lgesi, singulum t\u0131rnaklar\u0131 ile desteklenmi\u015ftir.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n&nbsp;\r\n<table class=\"aligncenter\" style=\"border-collapse: collapse;width: 100%\" border=\"0\"><caption><strong>\u015eekil 5-10.<\/strong> Arka hududu akrilikten tamamlanan tam palatal plaklar. a) ve c) Metal alt yap\u0131n\u0131n akrilik ile birle\u015fti\u011fi b\u00f6lgede akrili\u011fin tutuculu\u011fu i\u00e7in halkalar olu\u015fturulur. b) ve d) Metal ile akrili\u011fin birle\u015fim b\u00f6lgeleri d\u00fczg\u00fcn bir ge\u00e7i\u015f sa\u011flar.<\/caption>\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a.jpg\"><img class=\"alignnone size-medium wp-image-625\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-300x252.jpg\" alt=\"\" width=\"300\" height=\"252\" \/><\/a><\/td>\r\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b.jpg\"><img class=\"alignnone size-medium wp-image-626\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-300x237.jpg\" alt=\"\" width=\"300\" height=\"237\" \/><\/a><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">a<\/td>\r\n<td style=\"width: 50%\">b<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c.jpg\"><img class=\"alignnone size-medium wp-image-627\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-300x290.jpg\" alt=\"\" width=\"300\" height=\"290\" \/><\/a><\/td>\r\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d.jpg\"><img class=\"wp-image-628 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-300x276.jpg\" alt=\"\" width=\"300\" height=\"276\" \/><\/a><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 50%\">c<\/td>\r\n<td style=\"width: 50%\">d<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n&nbsp;\r\n\r\nAdezyon ve atmosferik tutuculuk sa\u011fla\u00admada, akrilik hudut metale g\u00f6re \u00fcst\u00fcnl\u00fck sa\u011flar. Bu durumda akrili\u011fin retansiyonuna elveri\u015fli a\u011f yap\u0131s\u0131 sa\u011flanmal\u0131d\u0131r.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>Do\u011fal di\u015flerin periodontal desteklerinin b\u00fc\u00ady\u00fck bir k\u0131sm\u0131n\u0131 kaybetti\u011fi durumlar,<\/li>\r\n \t<li>Rezid\u00fcel kretlerde ciddi rezorpsiyonlar\u0131n olu\u015ftu\u011fu vakalar,<\/li>\r\n \t<li>Sert dama\u011f\u0131n anatomik formunun d\u00fczle\u015f\u00admi\u015f oldu\u011fu vakalar,<\/li>\r\n \t<li>Damak yar\u0131\u011f\u0131 olan hastalar\u0131n hareketli b\u00f6\u00adl\u00fcml\u00fc protezle tedavisinde.<\/li>\r\n<\/ol>\r\n<strong>Kontrendikasyon:<\/strong>\r\n\r\nDi\u011fer ana ba\u011flay\u0131c\u0131lara g\u00f6re daha fazla olan doku \u00f6rt\u00fcm\u00fcn\u00fc tolere edemeyen hastalarda kullan\u0131lmaz.\r\n\r\n<strong>Alt \u00c7ene Ana Ba\u011flay\u0131c\u0131lar\u0131<\/strong>\r\n\r\nAlt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131 da a\u011f\u0131z taban\u0131ndaki gingival ve hareketli dokularla uyum i\u00e7inde olmal\u0131d\u0131r.\r\n<ul>\r\n \t<li>Alt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131:<\/li>\r\n \t<li>Lingual bar,<\/li>\r\n \t<li>\u00c7ift lingual bar,<\/li>\r\n \t<li>Lingual plak,<\/li>\r\n \t<li>Sublingual bar,<\/li>\r\n \t<li>Labial bar.<\/li>\r\n<\/ul>\r\n<h2>Lingual Bar<\/h2>\r\nKesiti yar\u0131m armut \u015feklinde olan ve kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu bir bar \u015feklindedir (\u015eekil 5-11). Yeterli rijiditeye sahip olabilmesi i\u00e7in en az 4 mm kal\u0131nl\u0131k ve geni\u015flikte olmal\u0131d\u0131r. Bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlanmal\u0131 ve a\u011f\u0131z taban\u0131ndaki dokular\u0131n fonksiyonel hareketleri\u00adne engel olmamal\u0131d\u0131r (\u015eekil 5-12).\r\n\r\n[caption id=\"attachment_648\" align=\"alignleft\" width=\"360\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11.jpg\">\u00a0<\/a><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11.jpg\"><img class=\"wp-image-648 \" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-300x130.jpg\" alt=\"\u015eekil 5-11. Lingual bar\u0131n kesiti, kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu yar\u0131m armut \u015feklindedir.\" width=\"360\" height=\"156\" \/><\/a> <strong>\u015eekil 5-11.<\/strong> Lingual bar\u0131n kesiti, kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu yar\u0131m armut \u015feklindedir.[\/caption]\r\n\r\n&nbsp;\r\n\r\n[caption id=\"attachment_650\" align=\"alignright\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12.jpg\"><img class=\"wp-image-650 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-300x190.jpg\" alt=\"\u015eekil 5-12. Lingual bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlan\u0131r.\" width=\"300\" height=\"190\" \/><\/a> <strong>\u015eekil 5-12.<\/strong> Lingual bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlan\u0131r.[\/caption]\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\nDolay\u0131s\u0131yla di\u015feti seviyesi ile a\u011f\u0131z mukozas\u0131 aras\u0131nda 6-8 mm\u2019lik mesafe gereklidir. Lingual bar alt \u00e7enenin lingual y\u00fczeyini yak\u0131ndan takip eder; ancak mukozayla aras\u0131nda r\u00f6lyef yap\u0131l\u0131r. Gerekli r\u00f6lyef miktar\u0131, lingual b\u00f6lgedeki yumu\u015fak dokuyla alt \u00f6n di\u015fler aras\u0131ndaki and\u0131rkat\u0131n e\u011fimine g\u00f6re belirlenir. Serbest sonlu hareketli b\u00f6l\u00fcml\u00fc protezlerde kaidenin rotasyonu mu\u00adkozada travmaya neden olaca\u011f\u0131ndan, di\u015fli sonlanan vakalara g\u00f6re daha fazla r\u00f6lyef gerektirir.\r\n\r\nAlt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131n\u0131n en basiti ve en kullan\u0131\u015fl\u0131s\u0131d\u0131r; di\u011fer alt \u00e7ene ana ba\u011flay\u0131c\u0131la\u00adr\u0131na temel olu\u015fturur. Gingival marjinleri a\u00e7\u0131kta b\u0131rak\u0131p, hi\u00e7bir di\u015f ve yumu\u015fak dokuya temas\u0131 olmad\u0131\u011f\u0131ndan, g\u0131da birikimi ve dental plaktan kaynaklanan \u00e7\u00fcr\u00fck ve di\u015feti enflamasyonu gibi rahats\u0131zl\u0131klar\u0131 azalt\u0131r.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n\r\n\u00d6zellikleri nedeniyle alt \u00e7enede hemen her vakada endikasyonu vard\u0131r.\r\n\r\n<strong>Kontrendikasyon:<\/strong>\r\n<ol>\r\n \t<li>Lingual sulkus ve gingival marjin aras\u0131nda 6 mm\u2019den az mesafe olan vakalar,<\/li>\r\n \t<li>Y\u00fcksek lingual frenuluma sahip vakalar,<\/li>\r\n \t<li>Lingual dokular\u0131n a\u015f\u0131r\u0131 e\u011fimli oldu\u011fu vakalar (\u015eekil 5-13),\r\n\r\n[caption id=\"attachment_651\" align=\"alignnone\" width=\"125\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13.jpg\"><img class=\"size-medium wp-image-651\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13-125x300.jpg\" alt=\"\u015eekil 5-13. Geni\u015f doku and\u0131rkat\u0131, lingual bar ile mukoza aras\u0131nda geni\u015f bir bo\u015flu\u011fa (A) neden olarak, dili rahats\u0131z eder.\" width=\"125\" height=\"300\" \/><\/a> <strong>\u015eekil 5-13.<\/strong> Geni\u015f doku and\u0131rkat\u0131, lingual bar ile mukoza aras\u0131nda geni\u015f bir bo\u015flu\u011fa (A) neden olarak, dili rahats\u0131z eder.[\/caption]<\/li>\r\n \t<li>\u00d6n di\u015flerin stabilizasyonu ve indirekt tutuculuk i\u00e7in ana ba\u011flay\u0131c\u0131ya ihtiya\u00e7 duyulan vakalar,<\/li>\r\n \t<li>Anterior di\u015flerin restorasyonunu gerektiren vakalar.<\/li>\r\n<\/ol>\r\n<h2>\u00c7ift Lingual Bar<\/h2>\r\nLingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden Kennedy bar\u0131 (sonsuz kro\u015fe) \u00e7ift lingual bar\u0131 olu\u015fturur (\u015eekil 5-14).\r\n\r\n[caption id=\"attachment_653\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14.jpg\"><img class=\"size-medium wp-image-653\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-300x225.jpg\" alt=\"\u015eekil 5-14. \u00c7ift lingual barda, lingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden ve premolarlar\u0131n mezialindeki yard\u0131mc\u0131 okluzal t\u0131rnakla desteklenen bir Kennedy bar\u0131 bulunur.\" width=\"300\" height=\"225\" \/><\/a> <strong>\u015eekil 5-14.<\/strong> \u00c7ift lingual barda, lingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden ve premolarlar\u0131n mezialindeki yard\u0131mc\u0131 okluzal t\u0131rnakla desteklenen bir Kennedy bar\u0131 bulunur.[\/caption]\r\n\r\nKennedy bar\u0131, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde u\u00e7 uca eklenmi\u015f stabilize edici kro\u015fe kollar\u0131 \u00f6zelli\u011finde olup, her iki u\u00e7ta yard\u0131mc\u0131 okluzal t\u0131rnaklarla desteklenir. B\u00f6ylece iyi bir indirekt tutucu olmalar\u0131 yan\u0131nda, proteze horizontal stabilite ve destek verirler. \u0130ki bar\u0131n ba\u011flant\u0131s\u0131 her iki u\u00e7ta yer alan iki min\u00f6r ba\u011flay\u0131c\u0131yla sa\u011flan\u0131r. Alt bar\u0131n yap\u0131s\u0131 lingual barda oldu\u011fu gibidir.\r\n\u00c7ift lingual bar g\u0131dalar\u0131n ve t\u00fck\u00fcr\u00fc\u011f\u00fcn interproksimal aral\u0131klardan serbest\u00e7e ak\u0131\u015f\u0131na ve dilin serbest di\u015feti \u00fczerindeki fizyolojik stim\u00fclasyonuna izin verir.\r\nSingulum b\u00f6lgesinde \u00f6zel dik a\u00e7\u0131l\u0131 t\u0131rnak yuvalar\u0131n\u0131n haz\u0131rlanmas\u0131 halinde, kuvvet iletimi di\u015flerin uzun eksenleri do\u011frultusunda olaca\u011f\u0131ndan daha iyi sonu\u00e7 verir.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>\u0130ndirekt tutuculu\u011fun sadece ana ba\u011flay\u0131c\u0131yla sa\u011flanabilece\u011fi serbest sonlu protezlerde,<\/li>\r\n \t<li>Alt keserler aras\u0131ndaki meziodistal temas uygun oldu\u011funda,<\/li>\r\n \t<li>Lingual dokular\u0131n a\u015f\u0131r\u0131 e\u011fimli olmad\u0131\u011f\u0131 vakalarda kullan\u0131labilir.<\/li>\r\n<\/ol>\r\n<strong>Kontrendikasyon:<\/strong>\r\n<ol>\r\n \t<li>\u00d6n grup di\u015fler aras\u0131nda \u00e7e\u015fitli nedenlerle olu\u015fmu\u015f diastema varl\u0131\u011f\u0131 (bu vakalarda Kennedy bar\u0131 aproksimal aral\u0131klar\u0131n alt hududundan ge\u00e7irilerek g\u00f6z\u00fckmemesi sa\u011flan\u0131r ve \u201ckesintili \u00e7ift lingual bar\u201d olu\u015fturulur.<\/li>\r\n \t<li>\u00d6n grup di\u015flerin klinik kron boylar\u0131n\u0131n k\u0131sa olu\u015fu,<\/li>\r\n \t<li>Y\u00fcksek seviyede lingual frenulum varl\u0131\u011f\u0131.<\/li>\r\n<\/ol>\r\n<h2>Lingual Plak<\/h2>\r\nAlt \u00f6n grup di\u015flerin lingual y\u00fczey konturlar\u0131na ve interproksimal embraz\u00fcrlere uyum sa\u011flayan bir plak \u015feklindedir. Lingual plak, interproksimal alanlar\u0131 kaplayan ve di\u015fle\u00adrin mezio-distal temas noktalar\u0131n\u0131n \u00fcst\u00fcne uzanan \u00e7\u0131k\u0131nt\u0131lar d\u0131\u015f\u0131nda, di\u015flerin orta \u00fc\u00e7l\u00fc\u00adlerinden daha yukar\u0131da yerle\u015ftirilmemelidir (\u015eekil 5-15).\r\n\r\n[caption id=\"attachment_657\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15.jpg\"><img class=\"size-medium wp-image-657\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-300x211.jpg\" alt=\"\u015eekil 5-15. Lingual plak, alt \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131na kadar uzan\u0131r.\" width=\"300\" height=\"211\" \/><\/a> <strong>\u015eekil 5-15.<\/strong> Lingual plak, alt \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131na kadar uzan\u0131r.[\/caption]\r\n\r\nPla\u011f\u0131n \u00fcst s\u0131n\u0131r\u0131 \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131nda olmal\u0131d\u0131r. Bu b\u00f6lgedeki di\u015flerin anatomik yap\u0131lar\u0131 ile uyum i\u00e7inde olan \u00fcst b\u00f6lgesinin kal\u0131nl\u0131\u011f\u0131 0.3 mm, alt b\u00f6lgesinin kal\u0131nl\u0131\u011f\u0131 ise 0.7 mm olacak \u015fekilde yar\u0131m armut bi\u00e7iminde haz\u0131rlan\u0131r (\u015eekil 5-16).\r\n\r\n[caption id=\"attachment_658\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16.jpg\"><img class=\"size-medium wp-image-658\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-300x287.jpg\" alt=\"\u015eekil 5-16. Lingual pla\u011f\u0131n \u00fcst ve alt kenarlar\u0131n\u0131n kal\u0131nl\u0131klar\u0131 birbirlerin\u00adden farkl\u0131d\u0131r.\" width=\"300\" height=\"287\" \/><\/a> <strong>\u015eekil 5-16.<\/strong> Lingual pla\u011f\u0131n \u00fcst ve alt kenarlar\u0131n\u0131n kal\u0131nl\u0131klar\u0131 birbirlerinden farkl\u0131d\u0131r.[\/caption]\r\n\r\nPlak arka gruba uzand\u0131\u011f\u0131 taktirde, g\u0131da birikimine engel olmak amac\u0131yla arka grup di\u015flerin kontur y\u00fcksekli\u011finin \u00fcst\u00fcnde sonlanmal\u0131d\u0131r. Pla\u011f\u0131n alt s\u0131n\u0131r\u0131 lingual sulkusta veya and\u0131rkat mevcut oldu\u011funda, lingual dokular\u0131n konturu hizas\u0131nda bitirilir.\r\n\r\nLingual b\u00f6lgedeki gingival dokular\u0131n plakla kapat\u0131l\u0131p bask\u0131 alt\u0131nda kalmas\u0131, kan dola\u015f\u0131m\u0131n\u0131, dilin fizyolojik stim\u00fclasyonunu ve t\u00fck\u00fcr\u00fck ak\u0131m\u0131n\u0131 engelledi\u011fi i\u00e7in di\u015feti sa\u011fl\u0131\u011f\u0131n\u0131 bozabilece\u011fi \u00f6ne s\u00fcr\u00fcl\u00fcr; bu nedenle fizyolojik a\u00e7\u0131dan tart\u0131\u015fmal\u0131 olan bir ana ba\u011flay\u0131c\u0131d\u0131r. A\u011f\u0131z hijyeni iyi olmayan hastalarda protezlerin s\u00fcrekli a\u011f\u0131zda kalmas\u0131na ba\u011fl\u0131 olarak, di\u015flerin lingual y\u00fczeylerinde a\u015f\u0131nma s\u00f6z konusu olabilir.\r\n\r\n<strong>Endikasyon:<\/strong>\r\n<ol>\r\n \t<li>\u00d6n di\u015flerin restorasyonunu gerektiren vakalar,<\/li>\r\n \t<li>\u0130ndirekt tutuculu\u011fa ihtiya\u00e7 duyulan vakalar,<\/li>\r\n \t<li>Lingual torusun cerrahi yolla giderilmesinin m\u00fcmk\u00fcn olmad\u0131\u011f\u0131 vakalar,<\/li>\r\n \t<li>A\u015f\u0131r\u0131 derecede y\u00fcksek lingual frenulum varl\u0131\u011f\u0131,<\/li>\r\n \t<li>A\u015f\u0131r\u0131 miktarda di\u015f ta\u015f\u0131 birikimi olan hastalar (fizyolojik stim\u00fclasyona engel oldu\u011fundan bu konu tart\u0131\u015fmal\u0131d\u0131r),<\/li>\r\n \t<li>Stabilizasyon \u00f6zelli\u011fi nedeniyle, periodontal deste\u011fi zay\u0131f olan \u00f6n di\u015fleri splintlemek amac\u0131yla,<\/li>\r\n \t<li>Prognozu belli olmayan ve yak\u0131n gelecekte kaybedilmesi d\u00fc\u015f\u00fcn\u00fclen \u00f6n di\u015flerin varl\u0131\u011f\u0131 (proteze di\u015f ilavesi yap\u0131labilmesi a\u00e7\u0131s\u0131ndan lingual plak kullan\u0131labilir).<\/li>\r\n<\/ol>\r\n<strong>Kontrendikasyon:<\/strong>\r\n\r\nGeni\u015f interproksimal aral\u0131klara sahip alt \u00f6n grup di\u015flerin varl\u0131\u011f\u0131nda lingual pla\u011f\u0131n kul\u00adlan\u0131m\u0131 estetik sak\u0131nca yarat\u0131r. Bu durumda lingual plak diastema b\u00f6lgelerinde di\u015flerin kolelerine do\u011fru girintili bir seyir g\u00f6sterecek \u015fekilde haz\u0131rlan\u0131r ve \u201ckesintili lingual plak\u201d ad\u0131n\u0131 al\u0131r (\u015eekil 5-17).\r\n\r\n[caption id=\"attachment_659\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17.jpg\"><img class=\"size-medium wp-image-659\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-300x227.jpg\" alt=\"\u015eekil 5-17. Alt \u00f6n di\u015flerde diastema mevcut oldu\u011funda, metalin labial y\u00fczden g\u00f6r\u00fcnmemesi i\u00e7in kesintili lingual plak kullan\u0131labilir.\" width=\"300\" height=\"227\" \/><\/a> <strong>\u015eekil 5-17.<\/strong> Alt \u00f6n di\u015flerde diastema mevcut oldu\u011funda, metalin labial y\u00fczden g\u00f6r\u00fcnmemesi i\u00e7in kesintili lingual plak kullan\u0131labilir.[\/caption]\r\n\r\n\u00d6n di\u015flerin labial y\u00fczeyinden bak\u0131ld\u0131\u011f\u0131n\u00adda ana ba\u011flay\u0131c\u0131 metalinin g\u00f6r\u00fcnmemesi i\u00e7in yap\u0131lan \u00f6zel bir tasar\u0131md\u0131r. Her bir di\u015fin lingual y\u00fczeyinde yer alan plak uzant\u0131lar\u0131n\u0131n geni\u015flikleri, destek ald\u0131klar\u0131 di\u015flerin meziodistal \u00e7aplar\u0131ndan daha dar olmal\u0131d\u0131r. Pla\u011f\u0131n yeterli rijiditeye sahip olabilmesi i\u00e7in alt s\u0131\u00adn\u0131rdaki kal\u0131nl\u0131\u011f\u0131 artt\u0131r\u0131labilir.\r\n<h2>Sublingual Bar<\/h2>\r\nSublingual bar lingual sulkusta seyreder. Daha a\u015fa\u011f\u0131da konumlanmas\u0131 d\u0131\u015f\u0131nda, yap\u0131sal olarak lingual bara benzer (\u015eekil 5-18).\r\n\r\n[caption id=\"attachment_660\" align=\"alignnone\" width=\"260\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18.jpg\"><img class=\"size-medium wp-image-660\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-260x300.jpg\" alt=\"\u015eekil 5-18. Yuvarlak \u015fekilli lingual sulkus \u00fczerine yerle\u015ftirilen sublingual bar.\" width=\"260\" height=\"300\" \/><\/a> <strong>\u015eekil 5-18.<\/strong> Yuvarlak \u015fekilli lingual sulkus \u00fczerine yerle\u015ftirilen sublingual bar.[\/caption]\r\n\r\nDili ve \u00f6zellikle de lingual frenulumu ra\u00adhats\u0131z etme olas\u0131l\u0131\u011f\u0131 nedeniyle kullan\u0131m\u0131 pek tercih edilmez; ancak yuvarlak \u015fekilli lingual sulkusa sahip hastalarda tolere edilebilir.\r\n<h2>Labial Bar<\/h2>\r\nAlt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fcze\u00adrinde yer al\u0131r veya baz\u0131 vakalarda arka grup di\u015flerin bukkaline kadar uzan\u0131r (\u015eekil 5-19).\r\n\r\n[caption id=\"attachment_661\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19.jpg\"><img class=\"size-medium wp-image-661\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-300x199.jpg\" alt=\"\u015eekil 5-19. Alt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fczerinde yer alan labial bar, arka grup di\u015flerin bukkaline kadar uzanabilir\" width=\"300\" height=\"199\" \/><\/a> <strong>\u015eekil 5-19.<\/strong> Alt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fczerinde yer alan labial bar, arka grup di\u015flerin bukkaline kadar uzanabilir[\/caption]\r\n\r\nLingual bar gibi kesiti yar\u0131m armut \u015feklin\u00addedir. Ayn\u0131 derecede rijidite elde edebilmek i\u00e7in labial bar\u0131n y\u00fckseklik ve kal\u0131nl\u0131\u011f\u0131 lingual bara g\u00f6re daha fazla olmal\u0131d\u0131r. Alveol konturunun d\u0131\u015f\u0131nda yer ald\u0131\u011f\u0131ndan, dudak ve labial mukoza aras\u0131ndaki metal kal\u0131nl\u0131\u011f\u0131 hastay\u0131 rahat\u00ads\u0131z eder.\r\n\r\nLabial bar kullan\u0131larak ba\u015far\u0131l\u0131 bir tedavi ger\u00e7ekle\u015ftirme \u015fans\u0131 \u00e7ok s\u0131n\u0131rl\u0131d\u0131r. Bu nedenle giri\u015f yolu problemine neden olan etkenlerin spesifik yakla\u015f\u0131mlarla giderilerek, olabildi\u011fince labial bar kullan\u0131m\u0131ndan ka\u00e7\u0131n\u0131lmas\u0131 tavsiye edilir.\r\n\r\nLinguale do\u011fru a\u015f\u0131r\u0131 derecede e\u011fimli olan \u00f6n di\u015fler ve premolarlar\u0131n varl\u0131\u011f\u0131nda tek se\u00ad\u00e7enektir (\u015eekil 5-20).\r\n\r\n[caption id=\"attachment_662\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20.jpg\"><img class=\"size-medium wp-image-662\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-300x206.jpg\" alt=\"\u015eekil 5-20. Linguale e\u011fimli alt \u00f6n di\u015flerin varl\u0131\u011f\u0131nda;a) Lingual bar\u0131n mukoza ile mesafesinin artt\u0131r\u0131lmas\u0131 gerekir. b) Labial bar\u0131n kullan\u0131m\u0131 daha do\u011fru olur.\" width=\"300\" height=\"206\" \/><\/a> <strong>\u015eekil 5-20.<\/strong> Linguale e\u011fimli alt \u00f6n di\u015flerin varl\u0131\u011f\u0131nda;<br \/><strong>a)<\/strong> Lingual bar\u0131n mukoza ile mesafesinin artt\u0131r\u0131lmas\u0131 gerekir.<br \/><strong>b)<\/strong> Labial bar\u0131n kullan\u0131m\u0131 daha do\u011fru olur.[\/caption]\r\n\r\n&nbsp;","rendered":"<p>\u00c7enelerin anatomik yap\u0131lar\u0131ndaki farkl\u0131l\u0131klar nedeniyle, alt ve \u00fcst \u00e7enede kullan\u0131lan ana ba\u011flay\u0131c\u0131lar\u0131n yap\u0131s\u0131 ve \u00e7e\u015fitleri birbirinden farkl\u0131d\u0131r.<br \/>\n\u00dcst \u00c7ene Ana Ba\u011flay\u0131c\u0131lar\u0131<br \/>\n\u00dcst \u00e7ene ana ba\u011flay\u0131c\u0131s\u0131n\u0131n dokuya oturacak i\u00e7 y\u00fczeyinde, periferal duvar boyunca, stop \u00e7izgisi olu\u015fturulur. Ana ba\u011flay\u0131c\u0131n\u0131n dokuya g\u00f6m\u00fclmesini \u00f6nleyen bu olu\u015fum ana ba\u011flay\u0131c\u0131yla doku aras\u0131nda iyi bir adaptasyon sa\u011flayarak, alt\u0131na g\u0131da ka\u00e7\u0131\u015f\u0131n\u0131 \u00f6nler. Stop \u00e7izgisi, hareketli b\u00f6l\u00fcml\u00fc protezin yap\u0131laca\u011f\u0131 ana model \u00fczerinde 0.5 &#8211; 1.0 mm derinlik ve geni\u015flikte oluk ha\u00adz\u0131rlanarak yap\u0131l\u0131r ve di\u015flerin gingival kenar\u0131ndan 6 mm uzakta sonlanmal\u0131d\u0131r. Stop \u00e7izgisinin derinli\u011fi, ana ba\u011flay\u0131c\u0131n\u0131n alt\u0131nda kalan dokunun reziliensine g\u00f6re belirlenir. Bu derinlik sert palatal mukozan\u0131n lateral e\u011fimleri boyunca daha derin, median palatal suturan\u0131n ge\u00e7ti\u011fi horizontal b\u00f6lgede ise daha s\u0131\u011f haz\u0131rlan\u0131r.<\/p>\n<p>\u00dcst \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131:<\/p>\n<ul>\n<li>Palatal bant,<\/li>\n<li>\u00c7ift damak bar\u0131,<\/li>\n<li>U-plak,<\/li>\n<li>Tam palatal plak.<\/li>\n<\/ul>\n<h2>Palatal Bant<\/h2>\n<p>Eksik di\u015flerin yerine ba\u011fl\u0131 olmas\u0131na ra\u011f\u00admen, s\u0131kl\u0131kla \u00f6n kenar\u0131 ruga seviyesinde, arka kenar\u0131 ise sert dama\u011f\u0131n ge\u00e7i\u015f b\u00f6lge\u00adsinde olmak \u00fczere, serbest di\u015feti kenarla\u00adr\u0131n\u0131 \u00f6rtmeyen ve e\u015fit kal\u0131nl\u0131kta olan bir bant \u00f6zelli\u011findedir. Damak \u00f6n b\u00f6lgesi a\u00e7\u0131kta b\u0131ra\u00adk\u0131ld\u0131\u011f\u0131ndan, fonasyona engel olmaz ve hasta i\u00e7in en rahat ana ba\u011flay\u0131c\u0131d\u0131r. Di\u015fsiz kretlerin daha k\u0131sa oldu\u011fu vakalarda daha dar, uzun oldu\u011fu vakalarda daha geni\u015f yap\u0131labilir; an\u00adcak en az 8 mm geni\u015fli\u011fe sahip olmal\u0131d\u0131r. Deformasyona direncini artt\u0131rmak amac\u0131yla, y\u00fczeyi dar, kal\u0131nl\u0131\u011f\u0131 fazla veya y\u00fczeyi geni\u015f, kal\u0131nl\u0131\u011f\u0131 ince yapmak gerekir. Sert damakla geni\u015f bir temas sahas\u0131 olu\u015fturdu\u011funda, iyi bir palatal destek sa\u011flayabilir. S\u0131kl\u0131kla kullan\u0131lan bir \u00fcst \u00e7ene ana ba\u011flay\u0131c\u0131s\u0131d\u0131r.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>Di\u015f destekli di\u015fsiz bo\u015fluklar\u0131n di\u015f ark\u0131n\u0131n her iki taraf\u0131nda simetrik olarak bulundu\u011fu Cl III modifikasyonlar\u0131 (\u015eekil 5-1),<br \/>\n<figure id=\"attachment_397\" aria-describedby=\"caption-attachment-397\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-397\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-300x233.jpg\" alt=\"\u015eekil 5-1. Palatal bant \u015feklindeki ana ba\u011flay\u0131c\u0131, modifikasyonlu Cl III gibi di\u015f destekli vakalarda daha dar olabilir.\" width=\"300\" height=\"233\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-300x233.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-65x51.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-225x175.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1-350x272.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-1.jpg 414w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-397\" class=\"wp-caption-text\"><strong>\u015eekil 5-1.<\/strong> Palatal bant \u015feklindeki ana ba\u011flay\u0131c\u0131, modifikasyonlu Cl III gibi di\u015f destekli vakalarda daha dar olabilir.<\/figcaption><\/figure>\n<\/li>\n<li>Damak \u00f6n b\u00f6lgesinin a\u00e7\u0131k b\u0131rak\u0131lmas\u0131n\u0131 gerektiren baz\u0131 Cl I ve II Mod. 1 (\u015eekil 5-2),<br \/>\n<figure id=\"attachment_398\" aria-describedby=\"caption-attachment-398\" style=\"width: 639px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-398 size-full\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2.jpg\" alt=\"\u015eekil 5-2. Cl I Mod 1(a) ve Cl II Mod 1 (b) vakalar\u0131nda oldu\u011fu gibi, sert damak deste\u011finin artt\u0131r\u0131lmas\u0131 istendi\u011finde, palatal bant daha geni\u015f haz\u0131rlanabilir.\" width=\"639\" height=\"269\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2.jpg 639w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2-300x126.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2-65x27.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2-225x95.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-2-350x147.jpg 350w\" sizes=\"auto, (max-width: 639px) 100vw, 639px\" \/><\/a><figcaption id=\"caption-attachment-398\" class=\"wp-caption-text\"><strong>\u015eekil 5-2.<\/strong> Cl I Mod 1<br \/><strong>(a)<\/strong> ve Cl II Mod 1<br \/><strong>(b)<\/strong> vakalar\u0131nda oldu\u011fu gibi, sert damak deste\u011finin artt\u0131r\u0131lmas\u0131 istendi\u011finde, palatal bant daha geni\u015f haz\u0131rlanabilir.<\/figcaption><\/figure>\n<\/li>\n<li>Kar\u015f\u0131t ark kavram\u0131 gere\u011fince, deste\u011fin di\u015fli ark k\u0131sm\u0131ndan sa\u011flanmas\u0131 amac\u0131yla Cl II ve Cl III vakalar\u0131 (\u015eekil 5-3 ).<\/li>\n<\/ol>\n<figure id=\"attachment_399\" aria-describedby=\"caption-attachment-399\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-399\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-300x242.jpg\" alt=\"\u015eekil 5-3. Cl III vakalar\u0131nda, kar\u015f\u0131t arktan destek almak amac\u0131yla palatal bant kullan\u0131labilir; ancak geni\u015fli\u011fi 8 mm\u2019den az olmamal\u0131d\u0131r.\" width=\"300\" height=\"242\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-300x242.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-65x52.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-225x182.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3-350x283.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/sekil-5-3.jpg 467w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-399\" class=\"wp-caption-text\"><strong>\u015eekil 5-3<\/strong>. Cl III vakalar\u0131nda, kar\u015f\u0131t arktan destek almak amac\u0131yla palatal bant kullan\u0131labilir; ancak geni\u015fli\u011fi 8 mm\u2019den az olmamal\u0131d\u0131r.<\/figcaption><\/figure>\n<p><strong>Kontrendikasyon:<\/strong><\/p>\n<ol>\n<li>Torus palatinus varl\u0131\u011f\u0131,<\/li>\n<li>Sert dama\u011f\u0131n anatomik formunun \u00e7ok sert ve d\u00fcz olmas\u0131,<\/li>\n<li>Di\u015fsiz sahalar\u0131n da\u011f\u0131l\u0131m\u0131n\u0131n uygun olmamas\u0131.<\/li>\n<\/ol>\n<h2>\u00c7ift Damak Bar\u0131<\/h2>\n<p>Anterior ve posterior b\u00f6lgede yer alan iki damak bar\u0131 \u015feklindedir. Rugan\u0131n girinti ve \u00e7\u0131k\u0131n\u00adt\u0131lar\u0131na g\u00f6re geni\u015f ve d\u00fcz olarak \u015fekillendirilen anterior bar dili rahats\u0131z edip fonasyona engel olmaz. Posterior bar ise anterior bara g\u00f6re daha kal\u0131n ve dar olacak \u015fekilde di\u015fsiz bo\u015flu\u011fun durumuna g\u00f6re yerle\u015ftirilir. Palatal banta g\u00f6re, deformasyona direnci daha iyidir; ancak doku deste\u011fi a\u00e7\u0131s\u0131ndan daha etkisizdir. Barlar d\u0131\u015f\u0131nda kalan k\u0131s\u0131mlar\u0131n a\u00e7\u0131k olu\u015fu hasta i\u00e7in rahatl\u0131k temin eder.<br \/>\n<strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>\u00d6n ve arka b\u00f6lgedeki destek di\u015fler aras\u0131ndaki mesafenin fazla oldu\u011fu modifikasyonlu Cl II (\u015eekil 5-4) ve Cl III vakalar\u0131 (\u015eekil 5-5),<\/li>\n<\/ol>\n<figure id=\"attachment_489\" aria-describedby=\"caption-attachment-489\" style=\"width: 300px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-489 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-300x225.jpg\" alt=\"\u015eekil 5-4. \u00d6n b\u00f6lgedeki bar\u0131 geni\u015f ve d\u00fcz, arka b\u00f6lgedeki bar\u0131 ise dar ve ince olarak haz\u0131rlanan \u00e7ift damak bar\u0131 modifikasyonlu Cl II vakalar\u0131nda kullan\u0131labilir.\" width=\"300\" height=\"225\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-300x225.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-768x577.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-65x49.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-225x169.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4-350x263.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-4.jpg 880w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-489\" class=\"wp-caption-text\"><strong>\u015eekil 5-4.<\/strong> \u00d6n b\u00f6lgedeki bar\u0131 geni\u015f ve d\u00fcz, arka b\u00f6lgedeki bar\u0131 ise dar ve ince olarak haz\u0131rlanan \u00e7ift damak bar\u0131 modifikasyonlu Cl II vakalar\u0131nda kullan\u0131labilir.<\/figcaption><\/figure>\n<figure id=\"attachment_565\" aria-describedby=\"caption-attachment-565\" style=\"width: 300px\" class=\"wp-caption alignright\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-565 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-300x210.jpg\" alt=\"\u015eekil 5-5. \u00c7ift damak bar\u0131, uzun di\u015fsiz kretlere sahip modifikasyonlu Cl III vakalar\u0131nda da kullan\u0131labilir.\" width=\"300\" height=\"210\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-300x210.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-65x45.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-225x157.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5-350x245.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-5.jpg 415w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-565\" class=\"wp-caption-text\"><strong>\u015eekil 5-5.<\/strong> \u00c7ift damak bar\u0131, uzun di\u015fsiz kretlere sahip modifikasyonlu Cl III vakalar\u0131nda da kullan\u0131labilir.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>2. Torus palatinus varl\u0131\u011f\u0131nda,<\/p>\n<p>3. Tam palatal pla\u011f\u0131 tolere edemeyen hastalar.<\/p>\n<p>4. \u00d6n b\u00f6lgedeki di\u015f eksikli\u011fini desteklemek \u00fczere Cl IV vakalar\u0131nda, palatal bant anterior b\u00f6lgeye uzat\u0131l\u0131r (\u015eekil 5-6).<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_616\" aria-describedby=\"caption-attachment-616\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-616\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-300x212.jpg\" alt=\"\u015eekil 5-6. Cl IV vakalar\u0131nda, \u00e7ift damak bar\u0131n\u0131n \u00f6n k\u0131sm\u0131, \u00f6n b\u00f6lgedeki di\u015fsiz krete kadar uzat\u0131l\u0131r. Major ba\u011flay\u0131c\u0131n\u0131n lateral b\u00f6l\u00fcmleri, di\u015flerin gingival marjinlerinden en az 6 mm uzakta konumlanmal\u0131d\u0131r.\" width=\"300\" height=\"212\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-300x212.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-65x46.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-225x159.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6-350x247.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-6.jpg 412w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-616\" class=\"wp-caption-text\"><strong>\u015eekil 5-6.<\/strong> Cl IV vakalar\u0131nda, \u00e7ift damak bar\u0131n\u0131n \u00f6n k\u0131sm\u0131, \u00f6n b\u00f6lgedeki di\u015fsiz krete kadar uzat\u0131l\u0131r. Major ba\u011flay\u0131c\u0131n\u0131n lateral b\u00f6l\u00fcmleri, di\u015flerin gingival marjinlerinden en az 6 mm uzakta konumlanmal\u0131d\u0131r.<\/figcaption><\/figure>\n<h2>U-Plak<\/h2>\n<p>Damak \u00f6n b\u00f6lgesini \u00f6rterek yan arka b\u00f6lgelere uzanan, at nal\u0131 \u015feklinde bir ana ba\u011flay\u0131c\u0131 tipidir (\u015eekil 5-7).<\/p>\n<figure id=\"attachment_618\" aria-describedby=\"caption-attachment-618\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-618 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-300x226.jpg\" alt=\"\u015eekil 5-7. U plak, damak \u00f6n b\u00f6lgesini \u00f6rten ve yan arka b\u00f6lgelere uzanan bir ana ba\u011flay\u0131c\u0131 tipidir.\" width=\"300\" height=\"226\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-300x226.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-65x49.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-225x169.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7-350x263.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-7.jpg 412w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-618\" class=\"wp-caption-text\"><strong>\u015eekil 5-7.<\/strong> U plak, damak \u00f6n b\u00f6lgesini \u00f6rten ve yan arka b\u00f6lgelere uzanan bir ana ba\u011flay\u0131c\u0131 tipidir.<\/figcaption><\/figure>\n<p>Hastaya rahats\u0131zl\u0131k vermemesi i\u00e7in en az 0.5 mm kal\u0131nl\u0131\u011f\u0131nda olmal\u0131d\u0131r. Fonasyon g\u00fc\u00e7l\u00fc\u00ad\u011f\u00fcn\u00fc azaltmak i\u00e7in damak \u00f6n y\u00fcz\u00fcndeki anatomik r\u00f6lyefleri a\u011f\u0131z bo\u015flu\u011funa bakan y\u00fczeyde aynen yans\u0131t\u0131r. M\u00fcmk\u00fcn oldu\u011funca gingival marjinler a\u00e7\u0131kta b\u0131rak\u0131l\u0131r.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>\u00d6n grup di\u015flerin restorasyonunu gerektiren modifikasyonlu Cl I vakalar\u0131,<\/li>\n<li>\u00d6n ve arka grup di\u015flerin restorasyonunu gerektiren vakalar,<\/li>\n<li>Torus palatinus\u2019un varl\u0131\u011f\u0131,<\/li>\n<li>Periodontal deste\u011fi zay\u0131f olan \u00f6n grup di\u015flerin stabilizasyonu gerekti\u011finde,<\/li>\n<li>Yumu\u015fak damak refleksi fazla olan hastalarda ve\/veya hastan\u0131n damak arka b\u00f6lgesinde doku \u00f6rt\u00fcm\u00fcn\u00fc tolere edemeyece\u011fi durumlar.<\/li>\n<\/ol>\n<p><strong>Kontrendikasyon:<\/strong><br \/>\nSerbest sonlu vakalarda, at nal\u0131 \u015feklindeki bu ana ba\u011flay\u0131c\u0131n\u0131n orta hat b\u00f6lgesinin dar ol\u00admas\u0131, rijiditesini azalt\u0131p, yeterli kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamayaca\u011f\u0131ndan, anterior di\u015flere kadar uzanmadan \u015fekillendirilmesi \u00f6nerilmez (\u015eekil 5-8).<\/p>\n<figure id=\"attachment_619\" aria-describedby=\"caption-attachment-619\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-619\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-300x265.jpg\" alt=\"\u015eekil 5-8. U pla\u011f\u0131n orta hat b\u00f6lgesindeki rijiditesinin azalmas\u0131 kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamad\u0131\u011f\u0131ndan, serbest sonlu vakalarda anterior di\u015flere kadar uzanmadan kullan\u0131m\u0131 \u00f6nerilmez.\" width=\"300\" height=\"265\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-300x265.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-65x57.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-225x198.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8-350x309.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-8.jpg 694w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-619\" class=\"wp-caption-text\"><strong>\u015eekil 5-8.<\/strong> U pla\u011f\u0131n orta hat b\u00f6lgesindeki rijiditesinin azalmas\u0131 kuvvet da\u011f\u0131l\u0131m\u0131 sa\u011flayamad\u0131\u011f\u0131ndan, serbest sonlu vakalarda anterior di\u015flere kadar uzanmadan kullan\u0131m\u0131 \u00f6nerilmez.<\/figcaption><\/figure>\n<h2>Tam Palatal Plak<\/h2>\n<p>Sert dama\u011f\u0131 m\u00fcmk\u00fcn oldu\u011fu kadar geni\u015f \u015fekilde kaplayan ve maksimum mukoza deste\u00ad\u011fi sa\u011flayan bir ana ba\u011flay\u0131c\u0131d\u0131r. B\u00f6ylece fonksiyonel y\u00fck geni\u015f sahaya da\u011f\u0131l\u0131p, birim y\u00fczeye d\u00fc\u015fen y\u00fck miktar\u0131 azal\u0131r ve fizyolojik avantaj sa\u011flar. Kaidenin fonksiyonel kuvvetler alt\u0131ndaki hareketi, artan adezyon kuvveti nedeniyle azal\u0131r.<\/p>\n<p>Sert dama\u011f\u0131n do\u011fal anatomik yap\u0131s\u0131n\u0131 pla\u011f\u0131n a\u011f\u0131z bo\u015flu\u011funa bakan y\u00fczeyine ay\u00adnen yans\u0131tmak amac\u0131yla ince olmas\u0131 gerekir; 0.35 mm kal\u0131nl\u0131k yeterlidir. Gingival marjinler m\u00fcmk\u00fcn oldu\u011funca a\u00e7\u0131kta b\u0131rak\u0131l\u0131r.<br \/>\nProtez kenarlar\u0131 arka b\u00f6lgede tam protez kaide hudutlar\u0131 gibi \u015fekillendirilir. Arka hudut metalle tamamlanabildi\u011fi gibi (\u015eekil 5-9) akrilikten de yap\u0131labilir (\u015eekil 5-10).<\/p>\n<table class=\"aligncenter\" style=\"border-collapse: collapse;width: 50.001%;height: 355px\">\n<tbody>\n<tr style=\"height: 340px\">\n<td style=\"width: 100%;height: 340px\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-621\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-300x258.jpg\" alt=\"\u015eekil 5-9. Arka hududu yumu\u015fak ve sert dama\u011f\u0131n birle\u015fim b\u00f6lgesinde yer alan tam palatal pla\u011f\u0131n \u00f6n b\u00f6lgesi, singulum t\u0131rnaklar\u0131 ile desteklenmi\u015ftir.\" width=\"300\" height=\"258\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-300x258.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-65x56.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-225x194.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9-350x301.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-9.jpg 719w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 100%\"><strong>\u015eekil 5-9.<\/strong> Arka hududu yumu\u015fak ve sert dama\u011f\u0131n birle\u015fim b\u00f6lgesinde yer alan tam palatal pla\u011f\u0131n \u00f6n b\u00f6lgesi, singulum t\u0131rnaklar\u0131 ile desteklenmi\u015ftir.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table class=\"aligncenter\" style=\"border-collapse: collapse;width: 100%\">\n<caption><strong>\u015eekil 5-10.<\/strong> Arka hududu akrilikten tamamlanan tam palatal plaklar. a) ve c) Metal alt yap\u0131n\u0131n akrilik ile birle\u015fti\u011fi b\u00f6lgede akrili\u011fin tutuculu\u011fu i\u00e7in halkalar olu\u015fturulur. b) ve d) Metal ile akrili\u011fin birle\u015fim b\u00f6lgeleri d\u00fczg\u00fcn bir ge\u00e7i\u015f sa\u011flar.<\/caption>\n<tbody>\n<tr>\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-625\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-300x252.jpg\" alt=\"\" width=\"300\" height=\"252\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-300x252.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-768x645.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-65x55.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-225x189.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a-350x294.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10a.jpg 877w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-626\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-300x237.jpg\" alt=\"\" width=\"300\" height=\"237\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-300x237.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-768x607.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-65x51.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-225x178.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b-350x277.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10b.jpg 824w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\">a<\/td>\n<td style=\"width: 50%\">b<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-627\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-300x290.jpg\" alt=\"\" width=\"300\" height=\"290\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-300x290.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-768x742.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-65x63.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-225x217.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c-350x338.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10c.jpg 874w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<td style=\"width: 50%\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-628 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-300x276.jpg\" alt=\"\" width=\"300\" height=\"276\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-300x276.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-65x60.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-225x207.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d-350x322.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-10d.jpg 411w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%\">c<\/td>\n<td style=\"width: 50%\">d<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>Adezyon ve atmosferik tutuculuk sa\u011fla\u00admada, akrilik hudut metale g\u00f6re \u00fcst\u00fcnl\u00fck sa\u011flar. Bu durumda akrili\u011fin retansiyonuna elveri\u015fli a\u011f yap\u0131s\u0131 sa\u011flanmal\u0131d\u0131r.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>Do\u011fal di\u015flerin periodontal desteklerinin b\u00fc\u00ady\u00fck bir k\u0131sm\u0131n\u0131 kaybetti\u011fi durumlar,<\/li>\n<li>Rezid\u00fcel kretlerde ciddi rezorpsiyonlar\u0131n olu\u015ftu\u011fu vakalar,<\/li>\n<li>Sert dama\u011f\u0131n anatomik formunun d\u00fczle\u015f\u00admi\u015f oldu\u011fu vakalar,<\/li>\n<li>Damak yar\u0131\u011f\u0131 olan hastalar\u0131n hareketli b\u00f6\u00adl\u00fcml\u00fc protezle tedavisinde.<\/li>\n<\/ol>\n<p><strong>Kontrendikasyon:<\/strong><\/p>\n<p>Di\u011fer ana ba\u011flay\u0131c\u0131lara g\u00f6re daha fazla olan doku \u00f6rt\u00fcm\u00fcn\u00fc tolere edemeyen hastalarda kullan\u0131lmaz.<\/p>\n<p><strong>Alt \u00c7ene Ana Ba\u011flay\u0131c\u0131lar\u0131<\/strong><\/p>\n<p>Alt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131 da a\u011f\u0131z taban\u0131ndaki gingival ve hareketli dokularla uyum i\u00e7inde olmal\u0131d\u0131r.<\/p>\n<ul>\n<li>Alt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131:<\/li>\n<li>Lingual bar,<\/li>\n<li>\u00c7ift lingual bar,<\/li>\n<li>Lingual plak,<\/li>\n<li>Sublingual bar,<\/li>\n<li>Labial bar.<\/li>\n<\/ul>\n<h2>Lingual Bar<\/h2>\n<p>Kesiti yar\u0131m armut \u015feklinde olan ve kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu bir bar \u015feklindedir (\u015eekil 5-11). Yeterli rijiditeye sahip olabilmesi i\u00e7in en az 4 mm kal\u0131nl\u0131k ve geni\u015flikte olmal\u0131d\u0131r. Bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlanmal\u0131 ve a\u011f\u0131z taban\u0131ndaki dokular\u0131n fonksiyonel hareketleri\u00adne engel olmamal\u0131d\u0131r (\u015eekil 5-12).<\/p>\n<figure id=\"attachment_648\" aria-describedby=\"caption-attachment-648\" style=\"width: 360px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-648\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-300x130.jpg\" alt=\"\u015eekil 5-11. Lingual bar\u0131n kesiti, kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu yar\u0131m armut \u015feklindedir.\" width=\"360\" height=\"156\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-300x130.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-1024x444.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-768x333.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-1536x666.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-2048x888.jpg 2048w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-65x28.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-225x98.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-11-350x152.jpg 350w\" sizes=\"auto, (max-width: 360px) 100vw, 360px\" \/><\/a><figcaption id=\"caption-attachment-648\" class=\"wp-caption-text\"><strong>\u015eekil 5-11.<\/strong> Lingual bar\u0131n kesiti, kal\u0131n k\u0131sm\u0131n\u0131 alt kenar\u0131n olu\u015fturdu\u011fu yar\u0131m armut \u015feklindedir.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_650\" aria-describedby=\"caption-attachment-650\" style=\"width: 300px\" class=\"wp-caption alignright\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-650 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-300x190.jpg\" alt=\"\u015eekil 5-12. Lingual bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlan\u0131r.\" width=\"300\" height=\"190\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-300x190.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-768x485.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-65x41.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-225x142.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12-350x221.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-12.jpg 883w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-650\" class=\"wp-caption-text\"><strong>\u015eekil 5-12.<\/strong> Lingual bar\u0131n \u00fcst kenar\u0131 alt \u00f6n di\u015flerin gingival marjinlerinden 2-3 mm uzakta seyreder. Alt kenar\u0131 ise lingual sulkusun 1 mm \u00fcst\u00fcnde konumlan\u0131r.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Dolay\u0131s\u0131yla di\u015feti seviyesi ile a\u011f\u0131z mukozas\u0131 aras\u0131nda 6-8 mm\u2019lik mesafe gereklidir. Lingual bar alt \u00e7enenin lingual y\u00fczeyini yak\u0131ndan takip eder; ancak mukozayla aras\u0131nda r\u00f6lyef yap\u0131l\u0131r. Gerekli r\u00f6lyef miktar\u0131, lingual b\u00f6lgedeki yumu\u015fak dokuyla alt \u00f6n di\u015fler aras\u0131ndaki and\u0131rkat\u0131n e\u011fimine g\u00f6re belirlenir. Serbest sonlu hareketli b\u00f6l\u00fcml\u00fc protezlerde kaidenin rotasyonu mu\u00adkozada travmaya neden olaca\u011f\u0131ndan, di\u015fli sonlanan vakalara g\u00f6re daha fazla r\u00f6lyef gerektirir.<\/p>\n<p>Alt \u00e7ene ana ba\u011flay\u0131c\u0131lar\u0131n\u0131n en basiti ve en kullan\u0131\u015fl\u0131s\u0131d\u0131r; di\u011fer alt \u00e7ene ana ba\u011flay\u0131c\u0131la\u00adr\u0131na temel olu\u015fturur. Gingival marjinleri a\u00e7\u0131kta b\u0131rak\u0131p, hi\u00e7bir di\u015f ve yumu\u015fak dokuya temas\u0131 olmad\u0131\u011f\u0131ndan, g\u0131da birikimi ve dental plaktan kaynaklanan \u00e7\u00fcr\u00fck ve di\u015feti enflamasyonu gibi rahats\u0131zl\u0131klar\u0131 azalt\u0131r.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<p>\u00d6zellikleri nedeniyle alt \u00e7enede hemen her vakada endikasyonu vard\u0131r.<\/p>\n<p><strong>Kontrendikasyon:<\/strong><\/p>\n<ol>\n<li>Lingual sulkus ve gingival marjin aras\u0131nda 6 mm\u2019den az mesafe olan vakalar,<\/li>\n<li>Y\u00fcksek lingual frenuluma sahip vakalar,<\/li>\n<li>Lingual dokular\u0131n a\u015f\u0131r\u0131 e\u011fimli oldu\u011fu vakalar (\u015eekil 5-13),<br \/>\n<figure id=\"attachment_651\" aria-describedby=\"caption-attachment-651\" style=\"width: 125px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-651\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13-125x300.jpg\" alt=\"\u015eekil 5-13. Geni\u015f doku and\u0131rkat\u0131, lingual bar ile mukoza aras\u0131nda geni\u015f bir bo\u015flu\u011fa (A) neden olarak, dili rahats\u0131z eder.\" width=\"125\" height=\"300\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13-125x300.jpg 125w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13-65x156.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13-225x542.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-13.jpg 287w\" sizes=\"auto, (max-width: 125px) 100vw, 125px\" \/><\/a><figcaption id=\"caption-attachment-651\" class=\"wp-caption-text\"><strong>\u015eekil 5-13.<\/strong> Geni\u015f doku and\u0131rkat\u0131, lingual bar ile mukoza aras\u0131nda geni\u015f bir bo\u015flu\u011fa (A) neden olarak, dili rahats\u0131z eder.<\/figcaption><\/figure>\n<\/li>\n<li>\u00d6n di\u015flerin stabilizasyonu ve indirekt tutuculuk i\u00e7in ana ba\u011flay\u0131c\u0131ya ihtiya\u00e7 duyulan vakalar,<\/li>\n<li>Anterior di\u015flerin restorasyonunu gerektiren vakalar.<\/li>\n<\/ol>\n<h2>\u00c7ift Lingual Bar<\/h2>\n<p>Lingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden Kennedy bar\u0131 (sonsuz kro\u015fe) \u00e7ift lingual bar\u0131 olu\u015fturur (\u015eekil 5-14).<\/p>\n<figure id=\"attachment_653\" aria-describedby=\"caption-attachment-653\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-653\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-300x225.jpg\" alt=\"\u015eekil 5-14. \u00c7ift lingual barda, lingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden ve premolarlar\u0131n mezialindeki yard\u0131mc\u0131 okluzal t\u0131rnakla desteklenen bir Kennedy bar\u0131 bulunur.\" width=\"300\" height=\"225\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-300x225.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-768x577.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-65x49.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-225x169.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14-350x263.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-14.jpg 880w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-653\" class=\"wp-caption-text\"><strong>\u015eekil 5-14.<\/strong> \u00c7ift lingual barda, lingual bar ile birlikte, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde seyreden ve premolarlar\u0131n mezialindeki yard\u0131mc\u0131 okluzal t\u0131rnakla desteklenen bir Kennedy bar\u0131 bulunur.<\/figcaption><\/figure>\n<p>Kennedy bar\u0131, alt \u00f6n di\u015flerin lingual y\u00fczeylerinde u\u00e7 uca eklenmi\u015f stabilize edici kro\u015fe kollar\u0131 \u00f6zelli\u011finde olup, her iki u\u00e7ta yard\u0131mc\u0131 okluzal t\u0131rnaklarla desteklenir. B\u00f6ylece iyi bir indirekt tutucu olmalar\u0131 yan\u0131nda, proteze horizontal stabilite ve destek verirler. \u0130ki bar\u0131n ba\u011flant\u0131s\u0131 her iki u\u00e7ta yer alan iki min\u00f6r ba\u011flay\u0131c\u0131yla sa\u011flan\u0131r. Alt bar\u0131n yap\u0131s\u0131 lingual barda oldu\u011fu gibidir.<br \/>\n\u00c7ift lingual bar g\u0131dalar\u0131n ve t\u00fck\u00fcr\u00fc\u011f\u00fcn interproksimal aral\u0131klardan serbest\u00e7e ak\u0131\u015f\u0131na ve dilin serbest di\u015feti \u00fczerindeki fizyolojik stim\u00fclasyonuna izin verir.<br \/>\nSingulum b\u00f6lgesinde \u00f6zel dik a\u00e7\u0131l\u0131 t\u0131rnak yuvalar\u0131n\u0131n haz\u0131rlanmas\u0131 halinde, kuvvet iletimi di\u015flerin uzun eksenleri do\u011frultusunda olaca\u011f\u0131ndan daha iyi sonu\u00e7 verir.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>\u0130ndirekt tutuculu\u011fun sadece ana ba\u011flay\u0131c\u0131yla sa\u011flanabilece\u011fi serbest sonlu protezlerde,<\/li>\n<li>Alt keserler aras\u0131ndaki meziodistal temas uygun oldu\u011funda,<\/li>\n<li>Lingual dokular\u0131n a\u015f\u0131r\u0131 e\u011fimli olmad\u0131\u011f\u0131 vakalarda kullan\u0131labilir.<\/li>\n<\/ol>\n<p><strong>Kontrendikasyon:<\/strong><\/p>\n<ol>\n<li>\u00d6n grup di\u015fler aras\u0131nda \u00e7e\u015fitli nedenlerle olu\u015fmu\u015f diastema varl\u0131\u011f\u0131 (bu vakalarda Kennedy bar\u0131 aproksimal aral\u0131klar\u0131n alt hududundan ge\u00e7irilerek g\u00f6z\u00fckmemesi sa\u011flan\u0131r ve \u201ckesintili \u00e7ift lingual bar\u201d olu\u015fturulur.<\/li>\n<li>\u00d6n grup di\u015flerin klinik kron boylar\u0131n\u0131n k\u0131sa olu\u015fu,<\/li>\n<li>Y\u00fcksek seviyede lingual frenulum varl\u0131\u011f\u0131.<\/li>\n<\/ol>\n<h2>Lingual Plak<\/h2>\n<p>Alt \u00f6n grup di\u015flerin lingual y\u00fczey konturlar\u0131na ve interproksimal embraz\u00fcrlere uyum sa\u011flayan bir plak \u015feklindedir. Lingual plak, interproksimal alanlar\u0131 kaplayan ve di\u015fle\u00adrin mezio-distal temas noktalar\u0131n\u0131n \u00fcst\u00fcne uzanan \u00e7\u0131k\u0131nt\u0131lar d\u0131\u015f\u0131nda, di\u015flerin orta \u00fc\u00e7l\u00fc\u00adlerinden daha yukar\u0131da yerle\u015ftirilmemelidir (\u015eekil 5-15).<\/p>\n<figure id=\"attachment_657\" aria-describedby=\"caption-attachment-657\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-657\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-300x211.jpg\" alt=\"\u015eekil 5-15. Lingual plak, alt \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131na kadar uzan\u0131r.\" width=\"300\" height=\"211\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-300x211.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-768x539.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-65x46.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-225x158.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15-350x246.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-15.jpg 880w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-657\" class=\"wp-caption-text\"><strong>\u015eekil 5-15.<\/strong> Lingual plak, alt \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131na kadar uzan\u0131r.<\/figcaption><\/figure>\n<p>Pla\u011f\u0131n \u00fcst s\u0131n\u0131r\u0131 \u00f6n di\u015flerin lingual y\u00fczeylerinin 1\/3 orta k\u0131s\u0131mlar\u0131nda olmal\u0131d\u0131r. Bu b\u00f6lgedeki di\u015flerin anatomik yap\u0131lar\u0131 ile uyum i\u00e7inde olan \u00fcst b\u00f6lgesinin kal\u0131nl\u0131\u011f\u0131 0.3 mm, alt b\u00f6lgesinin kal\u0131nl\u0131\u011f\u0131 ise 0.7 mm olacak \u015fekilde yar\u0131m armut bi\u00e7iminde haz\u0131rlan\u0131r (\u015eekil 5-16).<\/p>\n<figure id=\"attachment_658\" aria-describedby=\"caption-attachment-658\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-658\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-300x287.jpg\" alt=\"\u015eekil 5-16. Lingual pla\u011f\u0131n \u00fcst ve alt kenarlar\u0131n\u0131n kal\u0131nl\u0131klar\u0131 birbirlerin\u00adden farkl\u0131d\u0131r.\" width=\"300\" height=\"287\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-300x287.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-65x62.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-225x215.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16-350x335.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-16.jpg 638w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-658\" class=\"wp-caption-text\"><strong>\u015eekil 5-16.<\/strong> Lingual pla\u011f\u0131n \u00fcst ve alt kenarlar\u0131n\u0131n kal\u0131nl\u0131klar\u0131 birbirlerinden farkl\u0131d\u0131r.<\/figcaption><\/figure>\n<p>Plak arka gruba uzand\u0131\u011f\u0131 taktirde, g\u0131da birikimine engel olmak amac\u0131yla arka grup di\u015flerin kontur y\u00fcksekli\u011finin \u00fcst\u00fcnde sonlanmal\u0131d\u0131r. Pla\u011f\u0131n alt s\u0131n\u0131r\u0131 lingual sulkusta veya and\u0131rkat mevcut oldu\u011funda, lingual dokular\u0131n konturu hizas\u0131nda bitirilir.<\/p>\n<p>Lingual b\u00f6lgedeki gingival dokular\u0131n plakla kapat\u0131l\u0131p bask\u0131 alt\u0131nda kalmas\u0131, kan dola\u015f\u0131m\u0131n\u0131, dilin fizyolojik stim\u00fclasyonunu ve t\u00fck\u00fcr\u00fck ak\u0131m\u0131n\u0131 engelledi\u011fi i\u00e7in di\u015feti sa\u011fl\u0131\u011f\u0131n\u0131 bozabilece\u011fi \u00f6ne s\u00fcr\u00fcl\u00fcr; bu nedenle fizyolojik a\u00e7\u0131dan tart\u0131\u015fmal\u0131 olan bir ana ba\u011flay\u0131c\u0131d\u0131r. A\u011f\u0131z hijyeni iyi olmayan hastalarda protezlerin s\u00fcrekli a\u011f\u0131zda kalmas\u0131na ba\u011fl\u0131 olarak, di\u015flerin lingual y\u00fczeylerinde a\u015f\u0131nma s\u00f6z konusu olabilir.<\/p>\n<p><strong>Endikasyon:<\/strong><\/p>\n<ol>\n<li>\u00d6n di\u015flerin restorasyonunu gerektiren vakalar,<\/li>\n<li>\u0130ndirekt tutuculu\u011fa ihtiya\u00e7 duyulan vakalar,<\/li>\n<li>Lingual torusun cerrahi yolla giderilmesinin m\u00fcmk\u00fcn olmad\u0131\u011f\u0131 vakalar,<\/li>\n<li>A\u015f\u0131r\u0131 derecede y\u00fcksek lingual frenulum varl\u0131\u011f\u0131,<\/li>\n<li>A\u015f\u0131r\u0131 miktarda di\u015f ta\u015f\u0131 birikimi olan hastalar (fizyolojik stim\u00fclasyona engel oldu\u011fundan bu konu tart\u0131\u015fmal\u0131d\u0131r),<\/li>\n<li>Stabilizasyon \u00f6zelli\u011fi nedeniyle, periodontal deste\u011fi zay\u0131f olan \u00f6n di\u015fleri splintlemek amac\u0131yla,<\/li>\n<li>Prognozu belli olmayan ve yak\u0131n gelecekte kaybedilmesi d\u00fc\u015f\u00fcn\u00fclen \u00f6n di\u015flerin varl\u0131\u011f\u0131 (proteze di\u015f ilavesi yap\u0131labilmesi a\u00e7\u0131s\u0131ndan lingual plak kullan\u0131labilir).<\/li>\n<\/ol>\n<p><strong>Kontrendikasyon:<\/strong><\/p>\n<p>Geni\u015f interproksimal aral\u0131klara sahip alt \u00f6n grup di\u015flerin varl\u0131\u011f\u0131nda lingual pla\u011f\u0131n kul\u00adlan\u0131m\u0131 estetik sak\u0131nca yarat\u0131r. Bu durumda lingual plak diastema b\u00f6lgelerinde di\u015flerin kolelerine do\u011fru girintili bir seyir g\u00f6sterecek \u015fekilde haz\u0131rlan\u0131r ve \u201ckesintili lingual plak\u201d ad\u0131n\u0131 al\u0131r (\u015eekil 5-17).<\/p>\n<figure id=\"attachment_659\" aria-describedby=\"caption-attachment-659\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-659\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-300x227.jpg\" alt=\"\u015eekil 5-17. Alt \u00f6n di\u015flerde diastema mevcut oldu\u011funda, metalin labial y\u00fczden g\u00f6r\u00fcnmemesi i\u00e7in kesintili lingual plak kullan\u0131labilir.\" width=\"300\" height=\"227\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-300x227.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-65x49.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-225x170.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17-350x265.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-17.jpg 415w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-659\" class=\"wp-caption-text\"><strong>\u015eekil 5-17.<\/strong> Alt \u00f6n di\u015flerde diastema mevcut oldu\u011funda, metalin labial y\u00fczden g\u00f6r\u00fcnmemesi i\u00e7in kesintili lingual plak kullan\u0131labilir.<\/figcaption><\/figure>\n<p>\u00d6n di\u015flerin labial y\u00fczeyinden bak\u0131ld\u0131\u011f\u0131n\u00adda ana ba\u011flay\u0131c\u0131 metalinin g\u00f6r\u00fcnmemesi i\u00e7in yap\u0131lan \u00f6zel bir tasar\u0131md\u0131r. Her bir di\u015fin lingual y\u00fczeyinde yer alan plak uzant\u0131lar\u0131n\u0131n geni\u015flikleri, destek ald\u0131klar\u0131 di\u015flerin meziodistal \u00e7aplar\u0131ndan daha dar olmal\u0131d\u0131r. Pla\u011f\u0131n yeterli rijiditeye sahip olabilmesi i\u00e7in alt s\u0131\u00adn\u0131rdaki kal\u0131nl\u0131\u011f\u0131 artt\u0131r\u0131labilir.<\/p>\n<h2>Sublingual Bar<\/h2>\n<p>Sublingual bar lingual sulkusta seyreder. Daha a\u015fa\u011f\u0131da konumlanmas\u0131 d\u0131\u015f\u0131nda, yap\u0131sal olarak lingual bara benzer (\u015eekil 5-18).<\/p>\n<figure id=\"attachment_660\" aria-describedby=\"caption-attachment-660\" style=\"width: 260px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-660\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-260x300.jpg\" alt=\"\u015eekil 5-18. Yuvarlak \u015fekilli lingual sulkus \u00fczerine yerle\u015ftirilen sublingual bar.\" width=\"260\" height=\"300\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-260x300.jpg 260w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-65x75.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-225x260.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18-350x404.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-18.jpg 524w\" sizes=\"auto, (max-width: 260px) 100vw, 260px\" \/><\/a><figcaption id=\"caption-attachment-660\" class=\"wp-caption-text\"><strong>\u015eekil 5-18.<\/strong> Yuvarlak \u015fekilli lingual sulkus \u00fczerine yerle\u015ftirilen sublingual bar.<\/figcaption><\/figure>\n<p>Dili ve \u00f6zellikle de lingual frenulumu ra\u00adhats\u0131z etme olas\u0131l\u0131\u011f\u0131 nedeniyle kullan\u0131m\u0131 pek tercih edilmez; ancak yuvarlak \u015fekilli lingual sulkusa sahip hastalarda tolere edilebilir.<\/p>\n<h2>Labial Bar<\/h2>\n<p>Alt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fcze\u00adrinde yer al\u0131r veya baz\u0131 vakalarda arka grup di\u015flerin bukkaline kadar uzan\u0131r (\u015eekil 5-19).<\/p>\n<figure id=\"attachment_661\" aria-describedby=\"caption-attachment-661\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-661\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-300x199.jpg\" alt=\"\u015eekil 5-19. Alt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fczerinde yer alan labial bar, arka grup di\u015flerin bukkaline kadar uzanabilir\" width=\"300\" height=\"199\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-300x199.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-65x43.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-225x149.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19-350x232.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-19.jpg 413w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-661\" class=\"wp-caption-text\"><strong>\u015eekil 5-19.<\/strong> Alt \u00f6n grup di\u015flerin labial mukozas\u0131 \u00fczerinde yer alan labial bar, arka grup di\u015flerin bukkaline kadar uzanabilir<\/figcaption><\/figure>\n<p>Lingual bar gibi kesiti yar\u0131m armut \u015feklin\u00addedir. Ayn\u0131 derecede rijidite elde edebilmek i\u00e7in labial bar\u0131n y\u00fckseklik ve kal\u0131nl\u0131\u011f\u0131 lingual bara g\u00f6re daha fazla olmal\u0131d\u0131r. Alveol konturunun d\u0131\u015f\u0131nda yer ald\u0131\u011f\u0131ndan, dudak ve labial mukoza aras\u0131ndaki metal kal\u0131nl\u0131\u011f\u0131 hastay\u0131 rahat\u00ads\u0131z eder.<\/p>\n<p>Labial bar kullan\u0131larak ba\u015far\u0131l\u0131 bir tedavi ger\u00e7ekle\u015ftirme \u015fans\u0131 \u00e7ok s\u0131n\u0131rl\u0131d\u0131r. Bu nedenle giri\u015f yolu problemine neden olan etkenlerin spesifik yakla\u015f\u0131mlarla giderilerek, olabildi\u011fince labial bar kullan\u0131m\u0131ndan ka\u00e7\u0131n\u0131lmas\u0131 tavsiye edilir.<\/p>\n<p>Linguale do\u011fru a\u015f\u0131r\u0131 derecede e\u011fimli olan \u00f6n di\u015fler ve premolarlar\u0131n varl\u0131\u011f\u0131nda tek se\u00ad\u00e7enektir (\u015eekil 5-20).<\/p>\n<figure id=\"attachment_662\" aria-describedby=\"caption-attachment-662\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-662\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-300x206.jpg\" alt=\"\u015eekil 5-20. Linguale e\u011fimli alt \u00f6n di\u015flerin varl\u0131\u011f\u0131nda;a) Lingual bar\u0131n mukoza ile mesafesinin artt\u0131r\u0131lmas\u0131 gerekir. b) Labial bar\u0131n kullan\u0131m\u0131 daha do\u011fru olur.\" width=\"300\" height=\"206\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-300x206.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-768x527.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-65x45.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-225x154.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20-350x240.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/5-20.jpg 771w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-662\" class=\"wp-caption-text\"><strong>\u015eekil 5-20.<\/strong> Linguale e\u011fimli alt \u00f6n di\u015flerin varl\u0131\u011f\u0131nda;<br \/><strong>a)<\/strong> Lingual bar\u0131n mukoza ile mesafesinin artt\u0131r\u0131lmas\u0131 gerekir.<br \/><strong>b)<\/strong> Labial bar\u0131n kullan\u0131m\u0131 daha do\u011fru olur.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n","protected":false},"author":3,"menu_order":1,"template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-388","chapter","type-chapter","status-publish","hentry"],"part":213,"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":23,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/388\/revisions"}],"predecessor-version":[{"id":656,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/388\/revisions\/656"}],"part":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/213"}],"metadata":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/388\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=388"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapter-type?post=388"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=388"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}